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• ` iii iiiiiiiiiiiiiiii <br />. ,,,. 110 and 111 Attachment <br />Permittee Name: Fred L. Korinek <br />Operation Name: ~1Ca~/u,~ ~Vi)9i~*,P/cIJE,C RECEI~~ED <br />Permit No: 79-131 <br />Anniversary Date: duly 27 ~~~ U7 1984 <br />L71NED LAND RECLAMATION DIVISION <br />Colo. Dept, of Natural Resources <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />I~,I Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />~~•~ Annual Report <br />Remarks: <br />pc,~2iu~ 1~43`t-t4&4~ <br />~~~ <br />Kf./~ <br />/-~130~7 'o2,,Gbo, wo,e7k of ~ <br />~~/t$~ OuRli4ft TN~C f~/4ST <br />Signature <br />(Rev. 5/84) <br />Doc. No. 1782 <br />DiR7 1./O~/( S v •i=.4 R bar i/i/_S/= <br />~'/y/ ~5' <br />~~ ~- <br />/ICC'.c~ /~ Ac lgL~F,L-~ ~ r n~ ~J4N'`i <br />